The dose is determined by the level of concentration of lithium in the blood plasma. Is taken internally. For adults, the dose is 300-600 mg 3-4 times / day. The therapeutic concentration of lithium in plasma is 0.6-1 mmol / l.

For children under 12 years old - 15-20 mg 2-3 times / day.

The maximum daily oral dose for adults is 2.4 g.

Leukemia, severe surgery, pregnancy, lactation.

Application during pregnancy and lactation:

Contraindicated for use during pregnancy and lactation (breastfeeding).

Application for impaired renal function:

Use with caution in renal failure.

Application in children:

Sustained-release dosage forms should not be used in children under 12 years of age.

Elderly patients:

Elderly patients require dosage adjustment.

Dyspepsia, discomfort, myasthenia gravis, hand tremor, weakness, drowsiness, increased thirst, arrhythmias, inhibition of hematopoiesis, hypothyroidism, leukocytosis, increased body weight.

With prolonged use - impaired renal concentration, dysarthria, hyperreflexia, decreased urine output, collapse, coma.

Lithium preparations reduce the pressor effect of norepinephrine, as well as the mineral-corticosteroid effect of fludrocortisone, increase the neurotoxic effects of haloperidol; reduce the absorption of phenothiazines in the gastrointestinal tract, which leads to a decrease in their concentration in the blood by 40%; reduce the antidiuretic effect of carbamazepine, desmopressin, lipressin, hormones of the posterior pituitary gland (antidiuretic hormone); increase the risk of hypothyroidism when combined with calcium iodide, iodinated glycerin, potassium iodide; enhance the muscle relaxant effect of atracuria, pancuronium, ditilin; reduce the central stimulating effect of amphetamines.

Preparations containing sodium ions Na + or food products reduce the effectiveness of Li + preparations.

Urea, aminophylline, caffeine, diphyllin, choline theophyllinate, theophylline increase the excretion of Li + ions by the kidneys and reduce its pharmacological action.

Metronidazole, fluoxetine, diuretics, non-narcotic anti-inflammatory drugs (NSAIDs), angiotensin-converting enzyme inhibitors - slow down the excretion of Li + ions by the kidneys and increase its toxic effects.

Molindone stimulates the development of neurotoxicity (confusion, delirium, epileptic seizures, somnambulism or pathological changes in the electroencephalogram); methyldopa increases the risk of developing toxicity of Li + preparations even at normal plasma concentrations; blockers of "slow" calcium channels (BMCC) increase the incidence of neurotoxic complications (ataxia, tremor, nausea, vomiting, diarrhea, tinnitus).

When combined with antipsychotics, thymoleptics, neuroleptics, an increase in body weight is possible. Incompatible with ethanol containing beverages.

Elderly and debilitated patients require a dosage adjustment.

Nausea and vomiting, as early signs of lithium toxicity, may be masked by the antiemetic effects of some phenothiazines.

During the first month of therapy, the concentration of lithium in the blood plasma should be monitored weekly. When a stable concentration is reached, control is carried out monthly, then once every 2-3 months.

During the period of treatment, avoid alcohol consumption.

Do not use long-acting dosage forms in children under the age of 12 years, do not alternate with other dosage forms.

Influence on the ability to drive vehicles and use mechanisms

During the period of treatment, care should be taken when driving vehicles and engaging in other potentially hazardous activities that require increased attention and speed of psychomotor reactions.

Symptoms: early - diarrhea, drowsiness, loss of appetite, muscle weakness, nausea, vomiting, dysarthria, tremor; later - dizziness, blurred vision, impaired coordination of movement, polyuria, confusion, severe convulsions. Treatment: as a first aid, it is advisable to introduce a large amount of liquid and sodium chloride (sodium ions Na +); in severe cases, inpatient treatment is required.